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Yoga for Your Back: Once or Twice a Week?

Back pain relief similar with one weekly yoga practice vs. two weekly practices

Yoga can be therapeutic for the body in a number of ways. And for people with back pain, a little bit of yoga can go a long way.

A new study found that to relieve back pain and improve function in low-income minorities, a single yoga class once a week for several weeks did just as good a job as taking multiple yoga classes each week.

The study’s researchers suggested that structured yoga programs for low back pain should be implemented in healthcare and community settings.

This study led by Robert B. Saper, MD, MPH, director of Integrative Medicine at the Boston University Medical Campus, aimed to see if twice weekly yoga classes helped to relieve lower back pain among low-income, racially diverse populations.

The study included 95 adults who reported lower back pain and sought treatment at Boston Medical Center and five community health centers between May and December 2011.

More than 80 percent of the participants were non-white, and about three-quarters of the participants had a total household income of less than $40,000.

Patients who had back surgery, severe scoliosis, slipped spinal discs, spinal stenosis or fractures in the back were excluded from the study.

A little more than half the participants were assigned to do a yoga class once per week for 12 weeks, and the rest participated in yoga classes twice a week for the same duration.

Participants’ back pain levels and back-related functions were measured at the start of the study and after the end of the 12 weeks.

Before engaging in the yoga program, the participants had a back pain score of 6.9 out of 11 points on average, and scored a 13.7 out of 23 in function. Higher pain scores meant more pain while higher function scores meant less function.

The yoga classes were 75-minutes long, and the program consisted of four three-week segments. Each segment had a standard set of relaxation techniques, breathing techniques and yoga poses that increased in difficulty with each three-week segment.

Instructors included different pose variations and props in the sessions to accommodate any patient’s physical disabilities.

The participants were encouraged to practice 30 minutes a day at home on non-class days. They received a yoga mat, yoga block, audio CD and handbook illustrating each move for their home practice.

After completing the programs, the researchers found that pain and function levels improved in both yoga groups.

Between the once-per-week yoga group and the twice-per-week yoga group, there were no significant differences in scores. Pain decreased by 2.1 points in the once-per-week group and 2.4 points in the twice-per-week group.

Function level improved 5.1 points in the once-per-week yoga group and 4.9 points in the twice-per-week yoga group.

The researchers said that the twice-weekly classes might not have been more effective in treating back pain since those participants were less likely to adhere to the yoga practice than participants in the once-per-week group.

Further, the home practice was the same for both groups and both groups benefited most at week six of yoga.

“A much greater twice-weekly dose of 24 classes over 12 weeks may not therefore provide substantial marginal benefit over the once-weekly dose,” the researchers wrote in their report.

“Whether a six-week program is sufficient for long-term maintenance and effectiveness is unknown and requires further study,” they wrote.

Yoga is great for increasing core strength and flexibility, which is important for helping back pain, according to Rusty Gregory, a certified strength and conditioning specialist and dailyRx Contributing Expert.

“If the participants are practicing the poses at home as instructed, that once or twice a week class becomes performing yoga everyday,” Gregory said. “That could be why this study is showing similar results in one class versus two classes a week.”

The authors noted that their study was fairly small with some incomplete data, and the participants knew which yoga groups they were assigned to. The study also did not include a non-yoga group to compare results.

In addition, the researchers did not follow-up with participants over the long term, and they aren’t sure how yoga practice at home affected the results.

This study, which was funded by the National Center for Complementary and Alternative Medicine (NCCAM) and the National Institutes of Health, was published in the journal Evidence-Based Complementary and Alternative Medicine.